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🤢 Extended-Spectrum Beta-Lactamases (ESBL) & Antibiotics - #MEDSHED
Extended-spectrum beta-lactamase organisms hydrolyze penicillins, cephalosporins, and aztreonam. Bacteria with ESBL are defined by resistance to expanded-spectrum cephalosporins.
Gram negative rods have continued to mutate into an expansive list of beta-lactamase strains. The Ambler Classification divides them into groups, which I’ve listed above. Groups B-D are expanded resistance mechanisms of ESBL within Group A.
We know ESBL means non-beta lactams antibiotics can be considered. Carbapenems are preferred for invasive ESBL infections due to better outcomes compared to other agents. Carbapenems include ertapenem, meropenem, doripenem, and imipenem. Ertapenem does not cover Acinetobacter, Pseudomonas/Providencia, and Enteroccocus.
Tigecycline, considered a glyclcycline, is also used for ESBL-producing Enterbactericae. SMX-TMP and fluoroquinolones . Nitrofurantoin and fosfomycin are also available oral but limited to use for UTIs
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